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Clinical Aspects of Natural and Added Phosphorus in Foods pp 215–228Cite as

Dietary Phosphorus and Bone Disease

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Part of the book series: Nutrition and Health ((NH))

Abstract

The intake of phosphorus from foods, both inorganic and organic sources, may exert an adverse effect on the homeostatic regulation of calcium as well as of phosphate if it is too high or too low. This effect is especially true when the ratio of dietary calcium to dietary phosphorus is below 0.5–1 or greater than 1.5–1. These skewed dietary ratios stimulate hormonal responses of parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF-23) that result from altered serum concentrations of ionic calcium (Ca2+) and ionic phosphate (Pi2−). Skeletal responses to these hormones result in changes in bone, both cortical and cancellous, that may contribute to suboptimal structure and function. When phosphorus intake is too high, phosphate-induced bone loss may if the abnormal dietary intake pattern becomes prolonged; these conditions are referred to as hyperparathyroid-induced osteopenia or osteoporosis. High phosphorus intakes are of less concern in those individuals with reasonably healthy renal function because of the normal responses of FGF-23 and PTH that promptly act following meals. In those with declining renal function, as well as in chronic renal failure, concerns of bone loss from high phosphate intakes remain.

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Acknowledgments

Comments on this manuscript by Sanford C. Garner and Philip J. Klemmer are greatly appreciated. We also thank Liza Cahoon of the UNC Health Sciences Laboratory for her assistance with references.

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Authors and Affiliations

  1. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 27599-7461, NC, USA

    John J. B. Anderson PhD

  2. Clinical Pathology and Cell Biology, College of Physicians and Surgeons of Columbia University, New York, NY, 10032, USA

    David W. Dempster PhD

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  1. John J. B. Anderson PhD
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Correspondence to John J. B. Anderson PhD .

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Editors and Affiliations

  1. University of Alabama at Birmingham, Department of Medicine, School of Medicine, Birmingham, Alabama, USA

    Orlando M. Gutiérrez

  2. City Tower, Suite 400-ZOT:4088 UCI, School of Medicine, Orange, California, USA

    Kamyar Kalantar-Zadeh

  3. University of Washington, Professor of Medicine, and Section Head Harborview Medical Center, Seattle, Washington, USA

    Rajnish Mehrotra

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Anderson, J.J.B., Dempster, D.W. (2017). Dietary Phosphorus and Bone Disease. In: Gutiérrez, O., Kalantar-Zadeh, K., Mehrotra, R. (eds) Clinical Aspects of Natural and Added Phosphorus in Foods. Nutrition and Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6566-3_15

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  • DOI: https://doi.org/10.1007/978-1-4939-6566-3_15

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